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Article Dans Une Revue Journal of Sleep Research Année : 2021

European guideline and expert statements on the management of narcolepsy in adults and children

Ulf Kallweit
Geert Mayer
Joan Santamaria
Gert Lammers

Résumé

Background and purpose: Narcolepsy is an uncommon hypothalamic disorder of presumed autoimmune origin that usually requires lifelong treatment. This paper aims to provide evidence-based guidelines for the management of narcolepsy in both adults and children. Methods: The European Academy of Neurology (EAN), European Sleep Research Society (ESRS), and European Narcolepsy Network (EU-NN) nominated a task force of 18 narcolepsy specialists. According to the EAN recommendations, 10 relevant clinical questions were formulated in PICO format. Following a systematic review of the literature (performed in Fall 2018 and updated in July 2020) recommendations were developed according to the GRADE approach. Results: A total of 10,247 references were evaluated, 308 studies were assessed and 155 finally included. The main recommendations can be summarized as follows: (i) excessive daytime sleepiness (EDS) in adults-scheduled naps, modafinil, pitolisant, sodium oxybate (SXB), solriamfetol (all strong); methylphenidate, amphetamine derivatives (both weak); (ii) cataplexy in adults-SXB, venlafaxine, clomipramine (all strong) and pitolisant (weak); (iii) EDS in children-scheduled naps, SXB (both strong), modafinil, methylphenidate, pitolisant, amphetamine derivatives (all weak); (iv) cataplexy in children-SXB (strong), antidepressants (weak). Treatment choices should be tailored to each patient's symptoms, comorbidities, tolerance and risk of potential drug interactions. Conclusion: The management of narcolepsy involves non-pharmacological and pharmacological approaches with an increasing number of symptomatic treatment options for adults and children that have been studied in some detail.
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Dates et versions

hal-03649436 , version 1 (22-04-2022)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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Claudio Bassetti, Ulf Kallweit, Luca Vignatelli, Giuseppe Plazzi, Michel Lecendreux, et al.. European guideline and expert statements on the management of narcolepsy in adults and children. Journal of Sleep Research, 2021, 30 (6), pp.e13387. ⟨10.1111/jsr.13387⟩. ⟨hal-03649436⟩
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